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IHSS paramedical services

Paramedical services let IHSS pay for health-related tasks ordered by a physician — such as injections, bowel programs, or wound care — when the recipient cannot perform them independently and no licensed nurse is required.

  • Last verified 2026-06-24
  • 4 topics
  • Official sources

What counts as paramedical

California lists allowable paramedical tasks in IHSS regulations. They require training from a health professional and a signed plan — not independent medical judgment by the provider.

  • Insulin administration may qualify with proper training documentation.
  • Tasks beyond scope must be done by a nurse or home health agency.
  • County nurses may verify competency before authorizing hours.

California CDSS — Paramedical services

Physician orders and care plans

Obtain written orders describing frequency, technique, and monitoring. The county may require a paramedical services form completed by the doctor and the proposed provider.

  • Update orders when medications or wound status changes.
  • Keep supplies receipts if Medi-Cal separate billing applies.
  • Home health episodes may overlap briefly — coordinate tasks.

California CDSS — Paramedical services

Provider training requirements

Training must be documented by an RN, physician, or other qualified professional. Counties can deny paramedical hours if training sheets are incomplete.

  • Retrain after long gaps in performing the task.
  • Recipients can switch providers — training must transfer.
  • Mistakes can trigger APS reports — follow orders exactly.

California CDSS — Paramedical services

Billing paramedical time

Authorized paramedical hours appear separately on the notice of action. Bill only the time required to perform ordered tasks, not general supervision unless protective supervision is also approved.

  • Combine paramedical time with personal care in timesheets per county format.
  • Appeal if orders support more time than authorized.
  • Hospital discharge planners can request paramedical in the IHSS assessment.

California CDSS — IHSS

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